Serous borderline ovarian tumor with functioning stroma in a postmenopausal woman: immunohistochemical analysis of steroidogenic pathway.
An epithelial ovarian tumor with estrogenic manifestations (vaginal bleeding, vaginal softening) was encountered in a 70-year-old woman. The preoperative serum levels of estrone, estradiol, and testosterone were elevated. A right ovarian serous papillary tumor of borderline malignancy was removed and found to have a cellular, focally luteinized stroma. Steroidogenic enzymes, including 3beta-hydroxysteroid dehydrogenase and P450 cytochromes specific for cholesterol side-chain cleavage (P450scc), 17alpha-hydroxylation (P45017alpha), and aromatization (P450arom), were immunohistochemically demonstrated in the stromal cells. Immunohistochemical evaluation of these enzymes suggest significant functional differences among the enzymatically-activated stromal cells. That only rare stromal cells were immunoreactive for P450arom suggests that most of the testosterone synthesized in the tumor is extragonadally converted to estrogen, resulting in tumor-associated estrinism.
Yasuda
M
M
Department of Pathology, School of Medicine, Tokai University, Isehara, Kanagawa, Japan.
Itoh
J
J
Hirasawa
T
T
Hirazono
K
K
Shinozuka
T
T
Sasano
H
H
Osamura
R Y
RY
D015096:3-Hydroxysteroid Dehydrogenases / Q000378:metabolism; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D004848:Epithelium / Q000201:enzymology / Q000473:pathology; D004958:Estradiol / Q000097:blood; D004970:Estrone / Q000097:blood; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D010051:Ovarian Neoplasms / Q000097:blood* / Q000201:enzymology / Q000473:pathology*; D017698:Postmenopause; D017154:Stromal Cells / Q000473:pathology; D013739:Testosterone / Q000097:blood
D014408:Biomarkers, Tumor; D004970:Estrone; D013739:Testosterone; D004958:Estradiol; D003577:Cytochrome P-450 Enzyme System; D015096:3-Hydroxysteroid Dehydrogenases